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Background and purpose: Neuromuscular relaxants are one group of the important drugs in providing good condition for tracheal intubation and operation. Rapid intubation is needed in most situations. Also, most of non- depolarizing relaxants almost have long onset time. We compared the priming with pancrunium and atracurium in providing good and rapid relaxation for tracheal intubation.
Materials and Methods: In this prospective study, 65 patients with ASA class I, II were randomized into two groups. Group A received pancrunium and group B received atracurium. Primimg dose was injected as 20% of total dose of relaxant. Twitching response was measured with peripheral nerve stimulator. Intubation was done when % 80 of the twitching response disappeared. The time of total disappearance of twitching response was also recorded.
Results: The mean time for the injection of the first dose of relaxant until the time of intubation was 94.47 seconds in group A and 142.9 seconds in group B, which were significantly different (P<0/01). If intubation until the time of twitch response is detained, the time gap of group A will again be less than group B (P<0/01).
Conclusion: In priming technique, the time of tracheal intubation with pancrunium is significantly less than atracurium. So, considering the patient's condition and the need for rapid relaxation, pancrunium could be is a better relaxant than atracurium.

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Background and purpose: Stachys lavandulifolia is used for many diseases. In this study the toxic effect of alcoholic extract of this plant was investigated, in rats. Materials and methods: In present experimental study, 100 Wistar rats (about 250gr, 8-12 weeks old) were divided into 10 groups randomly (8 groups as case and 2 groups as control groups). Alcoholic extract of Stachys lavandulifolia was prepared by maceration method. Normal saline was injected to control groups and doses of 50, 100, 150 and 200mg/kg of the extracts were injected to others groups, intraperitoneally, daily, for 28 days. In 29th day, and one month later, the serum parameters level (ALP, AST, ALT) and pathological samples were evaluated in different groups. Results: On the first month there was significant increase of AST level at dose of 200mg/kg and ALP level at all doses compared to the control group (P<0.05). But there was no significant difference in the toxic effect of different concentrations of extract (P>0.05). On the second month, the liver enzymes changes was almost the same as first month, exception for dose of 150mg/kg that was increased significantly in AST level compared to control group and in ALP level compared to dose of 100mg/kg (P<0.05). The main histological finding was necroinflammatory and fibrotic reactions in liver at all doses, compared to control group (P<0.001). On the first month this hepatic damages significantly increased at the higher doses (150 and 200mg/kg) compared to lower doses (50 and 100mg/kg) of the extract (P<0.05). Conclusion: Extract of Stachys lavandulifolia caused toxicity effect in rate's liver, and therefore it should be use with caution.

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Background and purpose: Individuals treat the Internet phenomenon differently based on their personalities. Also, personality can predispose individuals for some psychological disorders. Some psychologists state that personality comes from nervous system functions, therefore, this study investigated the personality characteristics caused by brain-behavioral systems and gender on Internet addiction. Materials and methods: This casual-comparison research was performed in 225 people selected through cluster sampling from Internet cafes, libraries and gyms’ clients in Isfahan. The data was collected using Young’s Internet addiction scale and Gray-Wilson Personality Questionnaire. Results: Multivariate Variance Analysis (MANOVA) showed significant differences in brain-behavioral systems of addicted and non-addicted groups. Paired-test showed that these differences were due to differences in passive avoidance, and fight and flight subscales. Independent sample t-test also showed significant differences in Internet addiction between male and female. Moreover, multiple regression analysis confirmed the predicting role of passive avoidance and gender in Internet addiction. Conclusion: Behavioral inhibition system sensitivity could influence the risk factors of internet addiction. This is probably caused by enjoying the nature of Internet activities and delay in the negative outcomes at the same time. These are pleasant for individuals with high behavioral inhibition system sensitivity. Furthermore, males are more prone to Internet addiction that is due to more tendencies to develop social relations and gaining less family support than females.

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Background and purpose: One of the major complications of diabetes is retinopathy which is a highly specific vascular complication of type I and II diabetes. This study aimed at investigating the factors influencing the diagnosis of retinopathy in patients with type II diabetes using Cox, parametric, exponential, weibull, Log normal, and Log-logistic models and comparing their functions Material and Methods: This prospective cohort study included 400 patients with type II diabetes without retinopathy who were registered at Yazd Diabetes Research Center in 2008. They were followed up for diagnosis of retinopathy until February 2013. Significant variables in the univariate model for investigating the effective factors on diagnosis of retinopathy were entered in Cox multivariate and parametric models. The criterion to compare the performance of models was Akaike information criterion. Data was then analyzed in R software and 0.05 was considered as the significance level. Results: The mean and median periods to diagnose retinopathy were 46 and 58 months. Among the patients 3% were diagnosed with retinopathy in less than one year and in 16% the diagnosis was made in less than two years Conclusion: Some variables including anemia, taking aspirin, duration of diabetes, and using insulin were amongst the main risk factors for diagnosis of retinopathy (P<0.05). According to Akaike information criterion we found that Cox model best fits for determining factors influencing the diagnosis of retinopathy.

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Background and purpose: The Activities of Daily Living scale (ADL) and instrumental activities of daily living scale (IADL) are two instruments that screen elderly respondents for physical functioning. They also assess whether they are dependent or independent in performing their activities. This study was conducted to investigate the reliability and validity of Iranian version of ADL and IADL.

Materials and methods: ADL and IADL Persian versions were prepared by the forward-backward method. Content Validity Index (CVI) was also used. The questionnaire was given to 300 individuals. To determine the criterion validity, sensitivity and specificity of the ADL and IADL were calculated. To assess the construct validity convergent validity and known groups were used and ADL and IADL mean scores were compared using the Mini Mental State Examination (MMSE). Internal consistency and reliability was assessed by Cronbach's alpha and test-retest.

Results: The content validity index was more than 0.82 for both ADL and IADL. Convergent validity showed that the mean scores of ADL and IADL in elderly individuals with normal and adverse normal cognitive ability were significantly different. Also, the studied instruments were able to differentiate between different age groups. The sensitivity and specificity of ADL and IADL were 0.75 and 0.96, respectively. Cronbach'salpha and ICC were more than 0.75.

Conclusion: The Persian version of ADL and IADL were found to be consistent and valid measures for assessing daily activities and instrumental activities of Iranian elderly. They are also easy to use and are recommended for research projects.

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Background and purpose: Iodine is a trace element that has a major role in function of thyroid hormones. Disorders caused by iodine deficiency are the main preventable reasons for mental and physical problems. The purpose of this study was to determine the content of iodine in salt used in Kermanshah, Iran.

Materials and methods: Three hundred samples from 39 food suppliers were collected in various stages of production. Also, 100 salt samples (30 gr) from kitchens were randomly obtained. Standard methods were used for measuring the iodine level. Data was then analyzed using Kruskal-Wallis test.

Results: The mean content of iodine in salt samples supplied in Kermanshah was 28.3 ± 14.8 ppm, which was 50% less than the recommended level in Iran. The iodine level was within the standard range in only eight brands and 80% did not contain suggested level of iodine. Impurities were found in 3.1% of the samples. The iodine content reduced in salts as more time passed from production date (P= 0.14).

Conclusion: Most of the salts used in Kermanshah did not meet quality standards, therefore, continuous monitoring of iodine content in salt in production and distribution stages are recommended.

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Background and purpose: Many people with oral and dental diseases will see their physicians first, therefore, doctors must have enough knowledge about primary medical treatments. This research was conducted to study the knowledge of medical interns in Sari, Babol, and Mashhad medical schools about oral and dental diseases and also dental emergencies in 2013-2014.

Materials and methods: An analytical cross-sectional study was performed in 98 medical interns. A questionnaire was designed based on the books, scientific sources and available articles in this field. Content validity of the questionnaire was determined by four specialists. In order to evaluate the reliability of the questionnaire, the Test-retest method was used and the spearman correlation coefficient was 0.8. Data analysis was done in SPSS V.20 applying, ANOVA and Tukey test. P<0.05 was considered significant.

Results: The mean score for students' knowledge was 8.3. The mean knowledge scores of medical interns about oral and dental diseases were significantly different between the universities (P<0.004). The mean score was found to be higher in students at Babol University of Medical Sciences.

Conclusion: Low level of knowledge in oral and dental diseases among medical interns calls for further studies that could identify the factors causing this problem. Also, more training courses for interns and retraining of physicians are required.

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Oral hygiene products have been used widely among people since many years ago. Toothpaste and mouthwashes are the main products that are used for health and beauty and the demand for such dental products is high. These products include both chemical and herbal products. Plants form a large part of the surrounding nature, so they are the first choice for health problems. Nevertheless, due to the fast development of chemistry and lack of natural resources herbal products are replaced by chemical compounds. Compared with herbal products, chemical compounds are associated with more side effects, so using herbal drugs are more favorable and researchers are more interested to such products. In oral hygiene drugs the plant extracts affecting inflammation and bleeding are of significant interest to dental professionals. This article introduces one of the most common herbal drugs used as oral care product.

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Background andpurpose:Currently, leachate production and its management are major environmental problems associated with the operation of solid waste landfill. The aim of this study was to evaluate the efficiency of combined processes of coagulation, ozonation, and advanced oxidation using UV-activated oxone in treatment of landfill leachate of Zahedan, Iran.

Materials andmethods: This experimental-laboratory study included chemical coagulation using poly aluminum chloride (PAC), ozonation, and chemical oxidation using potassium peroxymonosulfate (oxone). For the purpose of this study, the effect of critical operating parameters on treatment of landfill leachate was investigated. These operating parameteres included: pH (3-8) and concentration of PAC (50-250 mg/l) in chemical coagulation process,time of ozonation (5-20 min), pH of solution (2-10), concentration of oxone reactant (150-750 mg/l), contact time with oxone (60-360 min), temperature (20-45ºC), and intensity of UV lamp in oxidation process using oxone (8, 15, 30 W).

Results: According to the results, the overall efficiency rates of this process in removal of total coliform, fecal coliform, total phosphorus, total nitrogen, biochemical oxygen demand (BOD), and chemical oxygen demand (COD)were 99%, 99%, 97%, 100%, 91.1%, and 85.62%, respectively, with optimum
PAC concentration= 250 mg/L, pH= 6 at the chemical coagulation phase, ozonation duration= 20 min,
reactiontime= 180 min during oxone-based oxidation process, oxone concentration= 750 mg/L, pH= 5, temperature= 25ºC, and UV lamp intensity= 8 W. Furthermore, the BOD₅/COD ratio increased from 0.42 to 0.72 after completion of the treatment process.

Conclusion:Current study showed that application of combined processes of chemical coagulation, ozonation, and advanced oxidation using UV-activated oxone are highlyefficient in removing major pollutants from waste landfill leachate.

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Background and purpose: Gastric cancer is the most common cancer associated with high mortality worldwide. One of the genes that is down-regulated in gastric cancer, is the SIRT3 that encodes the histone deacetylase enzyme. There is a variable number tandem repeat (VNTR) polymorphism in the intron 5 of SIRT3 gene and evidence shows that expression of SIRT3 gene increases by increase in the number of repeats. According to the deregulation of SIRT3 gene expression in gastric cancer and the effect of intron 5 VNTR polymorphism in the transcription, we investigated the association between intron 5 VNTR polymorphism of SIRT3 gene and the risk of developing gastric cancer.
Materials and methods: A case-control study was performed in 116 patients with gastric cancer (attending Isfahan Omid Hospital, Iran) and healthy controls (n= 116). After DNA extraction, all samples were genotyped using PCR and electrophoresis techniques and the results were analyzed applying logistic regression and Chi-square tests.
Results: In addition to the alleles that have been reported so far, alleles with 8 and 9 repeats were observed too, in this study. The results showed that genotype 4-1 increases significantly the risk of gastric cancer (P=0.028, OR= 13.00).
Conclusion: Some variants of intron 5 VNTR polymorphism SIRT3 gene is associated with risk of developing gastric cancer.
 
 

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Background and purpose: Interest into targeting PI3K in cancer has increased by the recent disclosure that aberrant activity of PI3K/Akt signaling pathway is associated with disease recurrence and poor outcome in different malignancies. The aim of this study was to investigate the potentiating effect of PI3K inhibitor, GS-1101 on doxorubicin-induced cell death in acute lymphoblastic leukemia-derived, Nalm-6 cells.
Materials and methods: In this experimental study, to evaluate whether abrogating PI3K/Akt pathway using GS-1101 could enhance cytotoxic effect of doxorubicin in acute lymphoblastic leukemia, Nalm-6 pre-B ALL cells were subjected to combination treatment and subsequent cell viability. Then cell count, metabolic activity, and transcriptional alteration of apoptosis-related target genes were investigated using Trypan blue exlussion, MTT and Rq-PCR analysis, respectively.
Results: Our data delineated that GS-1101 augments doxorubicin-induced cytotoxic and its anti-proliferative effect, as evidenced by the decreased cell survival, cellular metabolic activity, and reduction in the number of inhibitor-treated viable cells. Moreover, real-time PCR analysis revealed that induction of cell death by the drug combination was associated with increased Bax transcriptional activity (P≤0.01) followed by the elevated molecular ratio of Bax/Bcl-2 (P≤0.001).
Conclusion: This study suggested that abrogation of the PI3K pathway using GS-1101 could potentiate doxorubicin-induced anti-leukemic activity.
 

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Background and purpose: Karaj River is the biggest aquatic ecosystem in Alborz province which is exposed to a variety of pharmaceutical pollutants. These pollutants have adverse effects of on surface water, biota and even humans. This research aimed to evaluate the level of contamination caused by widely used antibiotics in Karaj River, effluent, and wastewater treatment plants in 20 stations.
Materials and methods: Sample preparation and filtration was done and concentrations of pharmaceutical pollutants were measured using HPLC (mobile phase). Data analysis was performed in SPSS V21.
Results: The mean concentrations of antibiotics in Karaj River were as follow: amoxicillin 2.305, erythromycin, 2.229, gentamicin 2.231, and cephalexin 2.325 µg/l. In treatments plants higher concentrations of these antibiotics were found: amoxicillin 7.240, erythromycin 7.301, gentamicin, 7.390, and cephalexin 6.779 µg/l. In wastewater treatment plants the mean concentrations of amoxicillin, erythromycin, gentamicin, and cephalexin were 5.289, 5.362, 5.344, and 4.608 µg/l, respectively.
Conclusion: According to the significant positive correlation between the concentration of such pollutants in water samples, sewage and wastewater, the main reasons for entering these pollutants are believed to be the pharmaceutical residue discharges in urine and sanitary sewer network, septic tanks and sewage discharge of untreated aquaculture facilities in Karaj River. Inefficient treatment processes in controlling and reducing antibiotics are the main causes of high concentration of these pollutants in the environment that needs urgent control.
 

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Background and purpose: Pharmaceutical products, particularly antibiotics are emerging contaminants that cause major environmental challenges due to cumulative effects, different adverse effects, and leading to drug resistance. The aim of this experimental study was to evaluate the efficiency of advanced oxidation process by persulfate activated by UV in removal of ofloxacin from aqueous solutions.
Materials and methods: In order to investigate the removal efficiency of ofloxacin, major operating parameters including initial pH of solution (2-12), the concentration of persulfate (50-3500 mg/l), concentrations of ofloxacin (2-100 mg/l), reaction time (6-30 min), and UV radiation (8,15,30 Watt) were studied.
Results: Maximum removal efficiency of ofloxacin and COD in optimal conditions (pH =6, persulfate concentration = 350 mg/l, ofloxacin concentration = 40 mg/l, reaction time =20 min and UV radiation = 8 watt) were 94.35% and 79.17%, respectively. Advanced oxidation with activated persulfate by UV, deceased the concentrations of ofloxacin and COD to 2.26 and 37.21 mg/l, respectively.
Conclusion: The results showed that using UV activated persulfate is an efficient method in removal of ofloxacin from aqueous solutions.
 

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Background and purpose: Polycyclic aromatic hydrocarbons (PAH) compounds are amongst the most hazardous environmental pollutants due to some features such as chemical stability, low degradation, bioaccumulation, and high toxicity for living organisms. Their resources are found in Persian Gulf beaches, so, this study aimed at investigating the concentration, source identification, and ecological risk of PAH compounds in coastal sediments in Pars Special Economic Energy Zone (PSEEZ), Iran.
Materials and methods: In order to assess the concentration of PAHs, 16 stations along the coast were selected and in each station two samples were collected. After preparation and extraction of samples using Soxhlet, the concentrations of these compounds were determined by HPLC. The toxicity evaluation indicators and diagnostic ratios were used to assess the ecological risk and determining their origin.
Results: Mean concentration of PAHs in sediment was 292.72±54.44 ng/g dry weight. The mean effects range-median quotient of the PAHs (M-ERM-Q, M-PEL-Q), toxic equivalence quotient (TEQ), and mutagenic equivalence quotient (MEQ) showed that current values were less than the permissible limit. Comparison of PAHs concentration with sediment quality standards (NOAA, SQGs, and EPA) showed that the values for all compounds were lower than the standard limits (PEC, TEC, PEL, TEL, ERM). However, among these compounds, the average concentration of Acl was higher than the ERL standard and the concentrations of Acl, Ace, and Phe were higher than the EPA toxicity threshold.
Conclusion: In this study, moderate PHAs pollution was seen in the region. Both petrogenic and fuel sources were found to be involved in introduction of these compounds into coastal sediments depending on the location of the station and its sources of contamination. Also, in terms of ecological risk, these compounds have low risks for living organisms.
 

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Background and purpose: Early treatment of thrombolysis can reduce mortality in patients with myocardial infarction, so, this systematic review and meta-analysis aimed to compare the effect of pre-hospital thrombolysis and in-hospital thrombolysis on short-term mortality in patients with myocardial infarction.
Materials and methods: Systematic search was conducted in electronic databases including Pubmed, Web of Science, Cochrane, and Embase without time and language constraints using related keywords. All articles were exported to EndNote. In initial search, 223 articles were found but finally 10 articles were selected for quality assessment, which was performed using the JADAD standard checklist for interventional studies and the Newcastle Ottawa Scale checklist for cohort studies. Comprehensive Meta-Analysis software was used for data analysis.
Results: The total samples size was 4291 in the pre-hospital group and 4,730 in the in-hospital group. Three clinical trials and all three cohort studies were found to have a good quality. Meta-analysis showed that thrombolytic therapy at the onset of symptoms and prior to patient's transfer to hospital could reduce mortality by 36% (OR= 0.64 CI 95%: 0.45-0.91).
Conclusion: Pre-hospital thrombolysis by emergency technicians can reduce mortality in patients with myocardial infarction.

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 An Evaluation of the Quality of Sleep Before and After Nowruz Holidays, Letter to Editor
 
Parisa Adimi Naghan¹,
Batoul Khoundabi²,
 Oldooz Aloosh³,
Javad Setareh^4,5
 
1 Associate Professor, Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
² Assistant Professor, Helal-e-Iran Applied Science Higher Education Institute (Red Crescent Society of Iran), Tehran, Iran
³ Pulmonologist, Clinical Research Development Unit of Shahid Beheshti Hospital, Hamadan University of Medical Sciences, Hamadan, Iran
⁴ Assistant Professor, Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
⁵ Department of Psychiatry, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
 

 

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Background and purpose: Association between vitamin D and anterior cruciate ligament injury (ACLI) in male athletes is poorly understood, and current data are not sufficient and consistent. The present study investigated the association between vitamin D and ACLI in some Iranian male athletes.
Materials and methods: This cross-sectional study was carried out in 100 male athletes with knee pain attending Sari Imam Khomeini Hospital, Iran 2016. They were evaluated into two groups: male athletes with ACL injury (AI group; n=50) and without ACL injury (WAI group; n=50). ACL injury was verified according to physical examination and MRI findings. Data, including the age, serum 25 (OH) D concentrations, body mass index (BMI), and previous history of exercise were recorded and analyzed in SPSS V20.
Results: The mean age of participants and their serum 25 (OH) D levels were 28±6 years and 25.07±1.02 ng/dl, respectively. There were no significant differences between the two groups in mean age, BMI, and previous history of exercise (P> 0.05). The mean serum 25 (OH) D levels were found to be significantly lower in AI group than those in WAI group (P< 0.001).
Conclusion: The current study showed that lower serum concentrations of 25 (OH) D are associated with the risk of ACLI in male athletes.

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 Background and purpose: Nowadays, widespread use of automated teller machines (ATMs), has increased the possibility of contamination of hands due to contact with the surfaces of these devices. This study aimed to investigate the prevalence of bacterial contamination and antibiotic resistance pattern of the isolated bacteria from the keyboard of these devices in Sari, north of Iran.
Materials and methods: In this descriptive-analytic study, the keyboards of 200 ATMs were sampled by sterile swab and transferred to the laboratory. The samples were inoculated in TSB medium and, after 24 hours of incubation at 37 ° C, were cultured on specific solid media and incubated. Then, the isolated bacteria were identified and their antibiotic resistance pattern was examined by disk agar diffusion method.
Results: Bacterial contamination was observed in 97% of the samples. Klebsiella pneumoniae was the most frequent identified bacteria (36.08%), while Bacillus cereus was the least frequent bacteria (1.54%). K. pneumoniae showed a high resistance rate against Tetracycline (91.42%) and a low resistance rate towards Imipenem (2.85%).
Conclusion: Regular disinfection of ATM keyboards has a significant role in reducing and controlling bacterial contamination. Also, due to increased antibiotic resistance of isolated bacteria, it is possible to combat this problem by precise monitoring on the performance of antimicrobial stewardship programs.

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Hepatitis B and C viruses are major public health problems. These viruses can chronically lead to liver disease such as fibrosis, cirrhosis, and hepatocellular carcinoma, which often increase mortality in these patients. According to previous studies, the liver is highly affected by changes in the microbiota of gastrointestinal tract and immune system damage caused by inflammation due to viral hepatitis. Significant advances have been made in identifying gastrointestinal microbiota in cirrhotic patients associated with viral hepatitis and its use in their prognosis and treatment in recent years. Unique bacterial profiles are observed in cirrhotic patients associated with viral hepatitis, including increased numbers of Streptococcus, Prevotella, Staphylococcus, and Enterococcus, as well as decreased numbers of Clostridium and Ruminococcus. The purpose of this review was to summarize and discuss the gastrointestinal microbiota profile in patients with chronic hepatitis B and C and its role in the progression of cirrhosis.

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Background and purpose: Colorectal cancer (CRC) is ranked as the second most common cancer in men and the third most common cancer in women worldwide. Routine treatments have many side effects and little efficiency. The aim of this study was to investigate the effects of Cold Atmospheric Plasma (CAP) on epigenetic changes of some genes involved in CRC progression.
Materials and methods: Proliferation rate of cells after 40 s treatment was analyzed using MTT assay. Gene expressions of Beclin-1, Runx3, and AIM2 were measured using Real time PCR and methylation alternations of mentioned genes were evaluated with quantitative Methylation-Specific PCR (Q-MSP).
Results: The viability of CAP-treated C26 cells significantly decreased compared to that of the L929 cells. The viability of C26 cell line decreased to75%, 52.2%, and 34% following 12, 24, and 48 hours of CAP therapy for 40 seconds. CAP therapy decreased the AIM2 expression (fold change=0.12) and increased the Runx3 gene expression (fold change=2.66) in C26 cell line. Also, treatment with CAP decreased the methylation level of Runx3 gene in CAP-treated cells compared with untreated cells (33.45% vs 63.24%).
Conclusion: This study confirmed the selective effect of CAP on cancer cells which is an ultimate goal of cancer therapy approach. Also, CAP treatment was found to affect gene expression and methylation level of critical players of CRC.